2 Weeks, 5 Days (GA: 30 Weeks)

Last night we were close to going to the ER again with more bleeding, but after calling Dr. Parker and getting a couple prescriptions, we avoided it.  Nanette is feeling much better today.  Eliza has been so cute these last couple days being a nurse to her mother.  She saw the bedside manner of nurses when she visited Nanette in the hospital for many weeks and imitates them precisely.  She knocks on the door, walks in, and asks, "Is there anything I can get you?"  Last night she did not want to go to bed at bedtime and said, "How can I go to sleep when I'm thinking about . . ."  Nanette assured her that she was going to get better.

Zeke is doing well.  He is off the hi-flow air and is now getting air straight from the wall.  It is still about 30% oxygen.  Dad got to hold him for about 45 minutes while he (i.e., Zeke) was getting his milk.

Gabe is off his CPAP.  He has been wearing a fabric helmet to help keep his CPAP canulla in place.  But since it is gone, I took some pictures.  Here's the best one:

As all the nurses keep telling me: He is a cutie!

Dr. Beacher and the fellow, Dr. Lang, showed me the images from all three of the head ultrasounds.  The first shows a dime sized whiter spot in Gabe's brain next to the each ventricle.  This is the PVL, or the dead white matter in Gabe's brain.  His ventricles were not symmetrical and were a bit loose around the edges---not evenly round as they should be.  They also pointed out areas of old bleeding.

The images from the last week showed that the ventricles were notably enlarged.  The ultrasound from Monday showed that the ventricles were significantly enlarged.  The images also showed a better picture of the extent of his PVL.

Let me back up a little.  An ultrasound image is a measure of density.  Light and dark images represent more or less dense matter.  When the cells die due to lack of blood, they are not necessarily echogenic, meaning that they may not have a sufficient density difference from the surrounding matter to show up in the image.

As the dead cells disintegrate and get absorbed back into the body, fluid-filled cysts remain.  These cysts show up as smaller black holes in the ultrasound image.  Gabe has many of these black holes in his brain.  Because of the significant white matter loss, the doctors are fairly sure that we can expect Gabe to have several developmental issues.  What these issues will be only time will tell.

Getting back to the enlarged ventricles:  The excess fluid in his brain may be due to 1) hydrocephalus caused by a blockage in the cerebrospinal fluid draining or 2) fluid back-fills the loss of pressure caused by the brain cells disintegrating.  The doctors are unsure which is causing Gabe's expanding ventricles.  Dr. Beachy told me it is 50/50 at this point.  They will do another ultrasound Thursday and then probably do a CT Scan thereafter.